Evidence map›Paper›PMID 40130400›Full record

Trial reportEuropean journal of neurology2025

Preventing Cardiomyopathy in Duchenne Muscular Dystrophy: Long-Term Follow-Up of Patients in the Randomised, Placebo-Controlled Drug-Trial of Perindopril and Bisoprolol.

John P Bourke, Andrew Bryant, Gregory Landon, Alexis Burn, Stefan Spinty, Ros Quinlivan, Zoya Alhaswani, Thomas Chadwick, Francesco Muntoni, Michela Guglieri and 1 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in European journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

John P BourkeDepartment of Cardiology, Freeman Hospital, Newcastle Hospitals Foundation Trust & John Walton Muscular Dystrophy Research Centre, Newcastle University, and Newcastle Hospitals Foundation Trust, Newcastle upon Tyne, UK.ORCID 0000-0001-7857-9073
Andrew BryantPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
Gregory LandonNIHR Great Ormond Street Hospital Biomedical Research Centre, Great Ormond Street Institute of Child Health, University College London, & Great Ormond Street Hospital Trust, London, UK.
Alexis BurnNewcastle Joint Research Office, Newcastle University/The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
Stefan SpintyDepartment of Paediatric Neurology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.
Ros QuinlivanCentre for Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery. Queen's Square, London, UK.
Zoya AlhaswaniDepartment of Paediatrics & Child Health, Birmingham Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Thomas ChadwickPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
Francesco MuntoniNIHR Great Ormond Street Hospital Biomedical Research Centre, Great Ormond Street Institute of Child Health, University College London, & Great Ormond Street Hospital Trust, London, UK.
Michela GuglieriJohn Walton Muscular Dystrophy Research Centre, Newcastle University, and Newcastle Hospitals Foundation Trust, Newcastle upon Tyne, UK.
DMD Heart Study Group

Funding

Duchenne UK 2021-06 NU-006994
6 · The paper itself

Abstract

introductionIt is uncertain whether using cardiac drugs prophylactically in combinations for DMD is better than ACE-inhibitor alone. Our previous study showed no differences in left ventricular function between perindopril-bisoprolol and matched placebo after 36 months.

methodsThis study aimed to determine whether heart measures diverged after 60-month total follow-up. All participants had commenced open-label perindopril and bisoprolol when the original study ended. All were reconsented for access to heart measures, undertaken as part of their clinical care. The primary outcome was the change in echo-measured ventricular ejection fraction from baseline according to original randomization.

resultsOf 75 participants reported originally, 65 (aged 16 ± 2.5 years) were re-recruited and had data for analysis. Adjusted primary outcomes included 44 participants (original arms: 'active' 21; 'placebo' 23), 48 for secondary outcomes, and 65 for 'headcount' analysis of those with ventricular dysfunction. Absolute LVEF% values reduced in both groups ('active': 62.5% ± 5.6% to 53.8% ± 4.0%; 'placebo': 60.6% ± 4.9% to 50.4% ± 8.5%). Despite trends favoring earlier introduction of therapy, change from baseline was similar between groups (adjusted mean difference: -7.7 (95% CI -16.4 to1.0%)). However, more in the 'placebo' arm had died, had reduced LVEF%, and were taking additional heart medications.

conclusionWhile some patients may have benefited from 'early' (active) as opposed to 'delayed' (placebo) initiation of perindopril and bisoprolol, group-mean ventricular function did not differ between study arms after 60 months. Small numbers, absence of a control group, insensitivity of echo-ejection fraction, and additional drug use probably prevented divergence between groups.

Indexed as

Angiotensin-Converting Enzyme InhibitorsBisoprololCardiomyopathiesMuscular Dystrophy, DuchennePerindoprilAdolescentAdrenergic beta-1 Receptor AntagonistsAdultFollow-Up StudiesHumansMaleTreatment OutcomeYoung AdultAdrenergic beta-1 Receptor AntagonistsAngiotensin-Converting Enzyme InhibitorsBisoprololPerindoprilACE‐inhibitorbeta‐blockercardiomyopathy preventionDMDheart medicationsprophylaxis

Identifiers

PMID40130400
PMCPMC11933849

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.